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Senior Director, Medical Cost Analytics

Remote

Hi, we're Oscar. We're hiring a Senior Director, Medical Cost Analytics to join our Actuarial team.

Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

The Senior Director, Medical Cost Analytics (MCA), plays an instrumental role in Oscar’s medical economics operating model, oversees and guides a team of analytically-minded professionals (e.g. actuaries, data scientists, statisticians) to guide next steps to support Oscar’s total cost of care (TCoC) strategy and efforts, and owns the architectural design of the trend management ecosystem from a toolkit perspective. As this role is important to ensuring Oscar’s future growth plan, the Senior Director, MCA, in collaboration with analytical leads across the forecasting, pricing, and network analytic units will be accountable to delivering business and operational solutions in response to developing trends within Oscar’s use base. This leadership position makes critical strategic decisions, has ownership of financial estimates, and communicates the findings to the Executive Leadership Committee.

You will report to the VP, Actuarial.

Work Location:

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.

If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.

You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $211,200 - $277,200 per year. The base pay for this role in all other locations is: $190,080 - $249,480 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities

  • Build decision-making responsibilities related to methodological process, tool design, model enhancements, and prioritization of programs focused on Total Cost of Care (TCoC).
  • Lead the design and execution of multi-faceted analytics projects.
  • Establish KPIs and success metrics across the MCA roadmap that ensures the appropriate design and evolution of Oscar’s approach to trend and affordability management.
  • Lead the MCA department encouraging a collaborative culture.
  • Provide mentorship, and development planning for team members to promote growth and learning across MCA.
  • Stay current with market trends, new technologies, and best practices within the healthcare analytics space to ensure that the MCA team remains on the the latest of innovation.
  • Develop relationships and communication with important cross-functional stakeholders across the operational teams — e.g. Payment Integrity, Utilization Management.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned.

Qualifications

  • Bachelor’s degree in a STEM field, or 4 years commensurate experience.
  • 12+ years of quantitative analysis in the healthcare industry.
  • 5+ years of collaborating and influencing the Executive Leadership Committee.

Bonus Points

  • Familiarity with ACA-specific healthcare laws, regulations, and compliance requirements.
  • Fellow of the Society of Actuaries (SOA), or on the track to become one.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency:  Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Notice to Job Applicants.

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Job Profile

Restrictions

Arizona California Colorado Connecticut Florida Georgia Illinois In-office requirement for local residents Iowa Kentucky Maine Maryland Massachusetts Michigan Minnesota Missouri Must reside in one of the following states Must reside in specified states Nevada New Hampshire New Jersey New Mexico New York North Carolina Ohio Oregon Pennsylvania Rhode Island South Carolina Tennessee Texas Utah Vermont Virginia Washington

Benefits/Perks

11 paid holidays Annual performance bonuses Company equity Company equity grants Dental Disability Insurance Employee benefits Equity grants Life and Disability insurance Medical Medical, dental, and vision benefits Paid holidays Paid parental leave Paid sick time Paid wellness time Paid wellness time and reimbursements Performance bonuses Unlimited Vacation Unlimited vacation program Vision Vision Benefits

Tasks
  • Collaboration
  • Compliance
  • Compliance with all applicable laws and regulations
  • Design trend management ecosystem
  • Develop relationships
  • Establish KPIs
  • Forecasting
  • Guide cost of care strategy
  • Lead analytics projects
  • Mentor team members
  • Other duties as assigned
  • Oversee analytics team
  • Stay current with market trends
Skills

Actuarial science Analytical Analytics C Collaboration Communication Compliance Cross-functional Collaboration Data Science Design Equity Forecasting Healthcare Healthcare Analytics Healthcare industry Health Insurance KPI development Leadership Medical Cost Analytics Mentorship Metrics Quantitative analysis Statistical analysis Strategy Team Leadership Technology Technology Platform Trend Management Utilization management

Experience

4 years

Education

Bachelor's degree Business Economics STEM

Certifications

Fellow of the society of actuaries